Neuromuscular and Pain Clinics: Comprehensive and multidisciplinary treatment of pain including back and neck pain, painful neuropathy, chronic migraines, phantom limb syndrome, complex regional pain syndrome, facial pain, radiculopathy, failed back syndrome and many other forms of chronic pain. We specialize in minimally invasive, effective outpatient procedures (see VIDEOS below). Our general treatment policy is: If a treatment is shown to be "better than a sugar pill (placebo)" in controled clinical trials (so-called evidence-based medicine) AND better than other existing treatments for a particular condition AND safe to the patient, we include it in our therapeutic armamentarium. This strategy always emphasizes an individualized approach to pain care. We disagree with offering fashionable "one fits all" concepts (such as "laser", "non-surgical decompression", etc.). Although these therapy modalities are also considered by us from time to time, we individualize treatments because the role of the pain generators vary substantially from person to person, as supported in the scientific and medical literature. We constantly research new emerging technologies. If any of these is shown effective and superior to others, we include it in our program.

Headache Clinic: We also offer the most current treatments for severe or chronic headache and refractory migraine syndromes including cervical spinal cord, peripheral nerve or nerve root stimulation to block pain transmission.

A fully equipped fluoroscopy suite is maintained on site for the patient’s convenience. Most procedures last 10-20 minutes and carry little discomfort to the patient. Patients are discharged home after the procedure. Heart rate and rhythm, respiratory rate, blood pressure, oxygen saturation, and EKG are monitored throughout some of the procedures. The procedures are fully discussed with the patient by Dr. Pappolla in advance, including potential outcomes, benefits, risks and alternative modalities for treatment. The patient always holds the final authority in deciding which treatment to pursue after being fully educated in the various modalities available. Ample time for discussion is always a high priority in our clinics.

Fluoroscopic guidance (x-ray image visualization) is almost always used to ensure correct and very accurate needle placement. This minimizes potential complications. Appropriate flow of dye is when appropriate documented before any medication is injected. This allows extreme accuracy and safety as opposed to blind injections.

If you prefer, you can click HERE to read or obtain a written explanation of some common procedures that you may print.

*Common conditions treated include at our clinics: back and spine pain caused by disk degeneration,neck and lower back pain caused by facet disease and arthritis or spondylosis (a synonym of arthritis or degenerative joint disease), back pain due to injuries,back pain due to trauma,leg pain due to sciatica also called radiculopathy,back and spine deformities associated with pain,complex back pain syndromes (co-existence of various causes for your pain sometimes associated with deconditioning, gait or balance abnormalities), lumbago, disk herniation, disk protrusion, slipped disk, root compression or pinched nerves,cervical or neck pain,fibromyalgia, back pain due to osteoporosis,low back pain and spine pain due to fractures,neck pain due to neurological disorders such as dystonia, neck or back pain following prior failed surgeries (failed back syndrome), back pain and neck pain associated with fibromyalgia, back and neck pain associated to myofascial pain syndrome, sciatica, slipped disks, degenerated disk, herniated disks, nerve compressions, carpal tunnel syndrome, neck pain or back pain associated with rigidity due to neuromuscular disorders such as parkinsonism and others. Neuropathy associated with metabolic disorders or diabetes. Migraine and refractory headaches, daily headaches, daily migraine, atypical migraine syndrome and atypical facial pain. Complex regional pain syndrome also called RSD or regional sympathetic dystrophy. Post-herpetic neuralgia. Trigeminal neuralgia. For more information on these conditions we recommend downloading and reading our Free Pain Report or visiting the web sites of reputable non profit organizations which provide unbiased information of the efficacy of various treatments available for your condition (some of the organizations we recommend are listed on the "links" page in this site.

For your protection

The internet is one of the greatest informational tools of our time. However, the abundance of information obtained, sometimes ambiguous or unverified, can lead to confusion or misinformation. For additional education on the mentioned terms (below) related to spine conditions we recommend that you also visit the LINKS page which will direct you to highly reputable non-profit organizations where you can do your own additional research independent of any bias. To this end, we also prepared a Pain Report for educational purposes. The information retrieved on searches using these terms is sometimes unverified by clinical trials or other evidenced-based medicine standards. For education on these terms, we highly recommend also (in addition to visiting the medical societies as mentioned above) to obtain information from other reputable sources such as the National Institutes of Health web site, WebMD or the American Medical Association website. You can then make an educated decision for yourself as to which information will conform with current standards of medical care in this country. Finally, note that most patients will use the term "doctor" on their searches. Remember to visit our page "about us". Therein, we describe what is considered acceptable regarding the credentials of a treating doctor. Often, your own primary care physician can be the best source for the answers to your questions.Common terms used by the public in the internet for searching information related spinal conditions frequently include: back pain doctor,back pain injuries,back pain trauma, spine doctor. Similar terms like lumbar back pain,pain orthopedics,pain specialist,back strain or back surgeons are frequently used in searches. Please use the listed non profit organizations to find additional information also when searching for "cervical pain or neck pain ,fibromyalgia,neuropathy, pinched nerve, slipped disk or back problems".